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OCD and Skin Picking

Is Skin Picking A Form of OCD?

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Updated August 24, 2010

Pathologic skin picking is a mental illness in which you compulsively pick your skin to remove small irregularities such as moles or freckles. Although classified as an impulse control disorder, it has been suggested that skin picking is related to OCD.

What are the Symptoms?

The main characteristic of pathologic skin picking, also referred to as psychogenic excoriation or dermatillomania, is repetitive or compulsive picking (or even digging) in the skin to point of causing skin damage, scarring and/or infection. It is not uncommon for people with skin picking to engage in picking for several hours per day. As a result, people who pick often have difficulty maintaining steady employment or interpersonal relationships.

When picking, people may use their fingers, tweezers, pins or other instruments to remove the blemish. Common areas of focus include the face, back, neck and scalp.

Although picking can involve normal skin, picking is most commonly triggered by small blemishes, imperfections, scabs and insect bites. Prior to picking many people describe a compulsion-like urge to pick at imperfections in the skin and a relief of anxiety when the imperfection is removed. Later, however, the person may feel shame or be embarrassed about his picking, which can often lead to depression.

Who is Affected?

Approximately 3% of the population is affected by pathological skin picking. Interestingly, most people seeking treatment are female. Skin picking can start at any age but usually begins in adolescence with the onset of skin conditions such as acne, eczema or psoriasis.

Not surprisingly, there appears to be a strong link between skin picking and OCD; skin picking occurs in people with OCD at a much higher rate than the general population. As well, skin picking is often tied to body dysmorphic disorder which involves a preoccupation with imagined bodily defects.

How is it Treated?

Skin picking often causes considerable embarrassment and distress as result of the unsightly wounds caused by picking as well as the lengths the affected person may have to go to conceal his picking (such as wearing long-sleeves during warm summer months or covering their face with a scarf)

Unfortunately, many people do not seek treatment because of the embarrassment associated with skin picking. This can be dangerous (or even life-threatening) as people often require medical interventions for their skin wounds, which are often infected.

Skin picking appears to respond best to treatment with a combination of selective serotonin reuptake inhibitors and cognitive-behavior therapy. If you are experiencing symptoms that think might be skin picking, speak with your doctor.

Source:

Hayes, S., Storch, E.A., Berlanga, L. “Skin picking behaviours: An examination of prevalence and severity in a community sample” Anxiety Disorders 2009 23: 314-319.

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